Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care.Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE.Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings.Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
Highlights
Dementia is a growing challenge for nations worldwide (Alzheimer’s Society, 2015; World Health Organisation, 2018)
Non-pharmacological interventions (NPIs) are thought to be a meaningful and preferred approach to care for people living with a dementia (PWD) (Cabrera et al, 2015)
The evaluation of whether these interventions were successful often relied on self-report measures or staff observations of behavioural and psychological symptom changes; factors such as social interaction and engagement had not been considered as important factors or useful outcomes in dementia care (Du Toit et al, 2019; Sung & Chang, 2005)
Summary
Dementia is a growing challenge for nations worldwide (Alzheimer’s Society, 2015; World Health Organisation, 2018). Non-pharmacological interventions (NPIs) are thought to be a meaningful and preferred approach to care for people living with a dementia (PWD) (Cabrera et al, 2015). These interventions include, for example, cognitive stimulation therapy (Orrell et al, 2017), singing (Camic et al, 2011), music and art therapies (Deshmukh et al, 2018; Raglio et al, 2015), talking therapies (Cheston & Ivanecka, 2017), and others. There has been an emphasis on promoting wellbeing for PWD through social engagement within their immediate environments (Martyr et al, 2018) Such an approach recognizes that focusing solely on emotional and behavioural outcomes to determine if an intervention is successful might pose a danger where interventions are “prescribed” to PWD based on those outcomes, without considering the individual’s personal choice. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting
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